Genicular artery embolization
Genicular artery embolization (GAE) is a minimally invasive image-guided procedure performed by interventional radiologists to relieve chronic knee pain caused by osteoarthritis (OA) or post-operative hemarthrosis. Technique and indicationsThe technique involves embolizing (blocking) small arteries around the knee, specifically the genicular arteries, to reduce inflammation and neovascularization that contribute to pain.[1] GAE is indicated for patients suffering from:
Mechanism and procedureDuring the procedure, a catheter is inserted through a small puncture, typically in the femoral or radial artery, and advanced under fluoroscopic guidance to the arteries supplying the knee joint. Embolic agents (microspheres) are injected into the genicular arteries to block abnormal vessels and reduce inflammation. This interruption in blood flow helps decrease synovial hyperplasia and pain associated with chronic inflammation.[3] GAE is usually conducted as an outpatient procedure under local anesthesia. The duration is between 1–2 hours. Patients can generally walk the same day and return to normal activities within 1–2 days. Post-procedural care involves monitoring for minor side effects such as skin discoloration or transient pain.[4] Outcomes and risksClinical studies have demonstrated that GAE results in significant reductions in pain scores (e.g., VAS, WOMAC). It can also lead to improved functional ability and quality of life, with high patient satisfaction.[5] Although generally safe, the procedure carries risks, including: skin discoloration or bruising, temporary numbness or tingling, and rare instances of non-target embolization (where embolic material is inadvertently deposited in unintended vessels or organs).[6] Research and clinical trialsMultiple studies have explored the efficacy of GAE. A pilot randomized study and subsequent case series report favorable outcomes in both short- and medium-term follow-up.[7][8] References
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